A participatory tool for assessing land footprint in city-region food systems-A case study from Metropolitan Copenhagen

The ongoing COVID-19 pandemic has exposed the fragility of current food systems to feed populations around the world. Particularly in urban centers, consumers have been confronted with this vulnerability, highlighting reliance on just-in-time logistics, imports and distant primary production. Urban food demand, regional food supply, land use change, and transport strategies are considered key factors for reestablishing resilient landscapes as part of a sustainable food system. Improving the sustainability of food systems in such circumstances entails working on the interrelations between food supply and demand, rural and urban food commodity production sites, and groups of involved actors and consumers. Of special significance is the agricultural land in close proximity to urban centers. Calling for more holistic approaches in the sense of inclusiveness, food security, citizen involvement and ecological principles, this article describes the use of a new decision support tool, the Metropolitan Foodscape Planner (MFP). The MFP features up-to-date European datasets to assess the potential of current agricultural land use to provide food resources (with special attention to both plant- and animal-based products) and meet the demand of city dwellers, and help to empower citizens, innovators, companies, public authorities and other stakeholders of regional food systems to build a more regionalized food supply network. The tool was tested in the context of the food system of the Copenhagen City Region in two collaborative workshops, namely one workshop with stakeholders of the Copenhagen City Region representing food consultancies, local planning authorities and researchers, and one in-person workshop masterclass with MSc students from the University of Copenhagen. Workshop participants used the tool to learn about the impacts of the current food system at the regional and international level with regard to the demand-supply paradigm of city-regions. The ultimate goal was to develop a participatory mapping exercise and test three food system scenarios for a more regionalized and sustainable food system and, therefore, with increased resilience to crises. Results from this implementation also demonstrated the potential of the tool to identify food production sites at local level that are potentially able to feed the city region in a more sustainable, nutritious and way.

Exploring alternative pathways toward more sustainable regional food systems by foodshed assessment – City region examples from Vienna and Bristol

The resilience of the food supply system has become a vital issue for many countries especially under substantial international supply disturbances (e.g. the effects of COVID-19 restrictions). Regionalizing diets and increasing food self-sufficiency contribute greatly to shortening food supply chains and, therefore, to increasing the resilience of the food system. Simultaneously, food supply disturbances can offer a chance for food system transition toward implementing sustainable management practices in agriculture (e.g. organic farming), increasing the sustainability of food production. In this study, we have proposed a foodshed for the cities of Vienna and Bristol, delineating the spatial extent for such a regionalization and self-sufficiency discussion. We used the Metropolitan Foodshed and Self-sufficiency Scenario model to assess the potential self-sufficiency of these areas under different pathways involving more sustainable and resilient food system scenarios by distinguishing: i) The regionalization, ii) production system, iii) food losses and wastage, and iv) population growth until 2050. Furthermore, we have found the main local food policies and studies involving both cities, linking them to the current self-sufficiency levels and proposing pathways to increase them. Our results suggest that the foodsheds proposed are suitable to achieve a high degree of potential self-sufficiency when shifting consumers’ behavior toward sustainably produced regional products, and reducing food wastes in households and food losses in agriculture. This should be accompanied in parallel by an increase in the diversification of regional crop production managed sustainably. We call for the adoption of the foodshed approach – based on the concept of sustainable city region food systems – so that it can be integrated into the food policies to increase food self-sufficiency sustainably.

Prognostic value of thrombin generation parameters in hospitalized COVID-19 patients.

SARS-CoV-2 infection increases the risk of thrombosis by different mechanisms not fully characterized. Although still debated, an increase in D-dimer has been proposed as a first-line hemostasis test associated with thromboembolic risk and unfavorable prognosis. We aim to systematically and comprehensively evaluate the association between thrombin generation parameters and the inflammatory and hypercoagulable state, as well as their prognostic value in COVID-19 patients. A total of 127 hospitalized patients with confirmed COVID-19, 24 hospitalized patients with SARS-CoV-2-negative pneumonia and 12 healthy subjects were included. Clinical characteristics, thrombin generation triggered by tissue factor with and without soluble thrombomodulin, and also by silica, as well as other biochemical parameters were assessed. Despite the frequent use of heparin, COVID-19 patients had similar thrombin generation to healthy controls. In COVID-19 patients, the thrombin generation lag-time positively correlated with markers of cell lysis (LDH), inflammation (CRP, IL-6) and coagulation (D-dimer), while the endogenous thrombin potential (ETP) inversely correlated with D-dimer and LDH, and positively correlated with fibrinogen levels. Patients with more prolonged lag-time and decreased ETP had higher peak ISTH-DIC scores, and had more severe disease (vascular events and death). The ROC curve and Kaplan Meier estimate indicated that the D-dimer/ETP ratio was associated with in-hospital mortality (HR 2.5; p = 0.006), and with the occurrence of major adverse events (composite end-point of vascular events and death) (HR 2.38; p = 0.004). The thrombin generation ETP and lag-time variables correlate with thromboinflammatory markers, and the D-dimer/ETP ratio can predict major adverse events in COVID-19.

Prognostic value of thrombin generation parameters in hospitalized COVID-19 patients (preprint)

Background. SARS-CoV-2 infection increases the risk of thrombosis by different mechanisms not fully characterized. Although still debated, an increase in D-dimer has been proposed as a first-line hemostasis test associated with thromboembolic risk and unfavorable prognosis. Objective. We aim to systematically and comprehensively evaluate the association between thrombin generation parameters and the inflammatory and hypercoagulable state, as well as their prognostic value in COVID-19 patientsMethods. A total of 127 hospitalized patients with confirmed COVID-19, 24 hospitalized patients with SARS-CoV-2-negative pneumonia and 12 healthy subjects were included. Clinical characteristics, thrombin generation triggered by tissue factor with and without soluble thrombomodulin, and also by silica, as well as other biochemical parameters were assessed.Results. Despite the frequent use of heparin, COVID-19 patients had similar thrombin generation than healthy controls. In COVID-19 patients, the thrombin generation lag-time positively correlated with markers of cell lysis (LDH), inflammation (CRP, IL-6) and coagulation (D-dimer), while the endogenous thrombin potential (ETP) inversely correlated with D-dimer and LDH, and positively correlated with fibrinogen levels. Patients with more prolonged lag-time and decreased ETP presented with increased ISTH-DIC scores, and had more severe disease (vascular events and death). The ROC curve and Kaplan Meier estimate indicated that the D-dimer/ETP ratio was associated with in-hospital mortality (HR 2.5; p=0.006), and with the occurrence of major adverse events (composite end-point of vascular events and death) (HR 2.38; p=0.004).Conclusions. The thrombin generation ETP and lag-time variables correlate with thromboinflammatory markers, and the D-dimer/ETP ratio can predict major adverse events in COVID-19.